HUBUNGAN LAMA MENJALANI HEMODIALISIS DENGAN GANGGUAN KOGNITIF PADA PENDERITA PENYAKIT GINJAL KRONIS

RUSTANTI, dr. Paryono Dahlan, Sp.S.

2013 | Tesis | S2 Kedokteran Klinik

Latar Belakang. Prevalensi gangguan kognitif pada penyakit ginjal kronis terjadi sekitar 37 % pada 336 pasien setelah dua tahun menjalani hemodialisis. Penelitian mengenai hubungan lama menjalani hemodialisis dengan gangguan kognitif belum pernah dilakukan di Indonesia. Tujuan penelitian ini yaitu untuk mengetahui hubungan lama menjalani hemodialisis dengan gangguan kognitif. Metode. Metode penelitian menggunakan potong lintang. Subjek penelitian didapatkan dari pasien penyakit ginjal kronis yang menjalani hemodialisis di RSUP Dr Sardjito Yogyakarta. Sampel diambil secara berurutan dan diwawancarai menggunakan kuisioner terstruktur. Gangguan kognitif menggunakan alat ukur Mini Mental State Examination (MMSE). Uji hipotesis analisis bivariat menggunakan uji chi-square dan uji t, sedangkan analisis multivariat menggunakan regresi logistik. Hasil. Jumlah subjek penelitian yang masuk dalam kriteria inklusi sebesar 64 subjek, terdiri dari 31(48,4%) subjek laki-laki dan 32(51,6%) subjek perempuan. Analisis bivariat lama hemodialisis tidak bermakna signifikan terhadap gangguan kognitif dengan RP 0,625 (95%CI 0,365-1,166). Variabel lain yang bermakna signifikan terhadap gangguan kognitif adalah anemia dan hipotensi selama dialisis. Hasil analisis multivariat variabel independen yang bermakna secara signifikan terhadap gangguan kognitif hipotensi selama dialisis (95%CI;p=0,001;RP=13,091). Kesimpulan. Lama hemodialisis tidak berhubungan dengan gangguan kognitif namun didapatkan korelasi negatif antara lama hemodialisis dengan gangguan kognitif.

Background. The prevalence of cognitive impairment in chronic kidney diseases occurs about 37% on 336 patients after two years haemodialisis treatment. Research on long-standing relationships undergoing hemodialysis with cognitive impairment has not been done in Indonesia. The aim of this reasearch is to determine about long-standing relationships undergoing hemodialysis with cognitive impairment. Methods. The method uses cross-sectional sudy. Research subjects obtained from chronic kidney disease patients undergoing hemodialysis at RSUP Dr. Sardjito Yogyakarta. Samples were taken in sequence and were interviewed using a structured questionnaire. Cognitive impairment using a measuring instrument Mini Mental State Examination (MMSE). Hypothesis testing bivariate analysis using Chi-square and ttest, while multivariate analysis using logistic regression. Results. The number of subjects who entered the study inclusion criteria of 64 subjects, consisting of 31 (48.4%) male subjects and 32 (51.6%) female subjects. Bivariate analysis was not significantly longer hemodialysis significant cognitive impairment with RP 0.625 (95% CI 0.365 to 1.166). Other variables which significant with cognitive impairment are anemia and hypotension during dialysis. The results of multivariate analysis significant independent variables significantly to cognitive impairment in order are hypotension during dialysis (95% CI, p = 0.001; PR = 13.091). Conclusion. Lenght of hemodialysis study was not associated with cognitive impairment but has negative correlation with MMSE score.

Kata Kunci : Penyakit ginjal kronis, hemodialisis, gangguan kognitif